The Legislature Should Support Countywide Health Care District

January 25, 1987

Palm Beach County`s proposed county-wide Health Care District deserves the support of the Legislature, which hould see in this idea a statewide solution to indigent health care.

Unfortunately, the plan faces a formidable political foe even before it has taken the form of a bill. House Speaker Jon Mills, D-Gainesville, is considering imposing a one-year moratorium on new taxing districts.

Mills` intent is laudable -- to get control of a growing network of small, independent taxing districts and force local governments to take more comprehensive approaches to common problems. Palm Beach County is especially guilty of a proliferation of taxing districts, with more than 100 to its name.

Creation of a countywide Health Care District may seem like further excess, but creation of one district will eliminate three existing hospital taxing districts and institute a comprehensive approach to indigent health care. Not even the state has gone so far in planning health services for the poor.

Mills and other legislators should see the logic of this tax plan and the equity it would provide for county hospitals, some of which carry a disproportionate burden in caring for the poor.

Currently, the County Commission pays $10.6 million a year for indigent health care. Taxing districts for Bethesda Memorial Hospital in Boynton Beach and two hospitals in the Glades provide $12.7 million a year in care for the poor. That leaves $15 million a year in uncompensated indigent care, with $14 million of that absorbed by St. Mary`s Hospital in West Palm Beach. St. Mary`s is not covered by a special taxing district, but would be under the Health Care District.

The plan also would spread the cost of indigent care more equitably among county taxpayers, most of whom do not now pay taxes to a hospital district.

Both the Palm Beach County Commission and the county`s Legislative Delegation must act to move the Health Care District forward.

First, the commission should create a fourth health taxing district that was authorized some years ago by the Legislature for the northeast section of the county. This district would oversee indigent care for areas not already covered by the three existing hospital taxing districts. It would also provide the administrative structure for a countywide health care district.

The county`s lawmakers then should adopt the proposal as a local bill, but not before paring down a proposed maximum tax rate of $5 for each $1,000 of assessed property value. It is far too high, equalling half the maximum rate that municipalities are allowed to charge taxpayers, and such a large authorization is not needed at this time. With that one amendment, the proposal should be ready for adoption.